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Wotherspoon J, Whittingham K, Sheffield J, Boyd RN. Randomised controlled trial of an online cognitive training program in school-aged children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 150:104752. [PMID: 38797157 DOI: 10.1016/j.ridd.2024.104752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/14/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Children with cerebral palsy (CP) experience deficits in nonverbal reasoning. The SMART online cognitive intervention has been associated with gains in IQ and nonverbal IQ in previous studies in typically developing school-aged children and children experiencing learning difficulties. AIM To assess the efficacy of an online cognitive intervention in school-aged children with CP. METHODS AND PROCEDURES 21 children with CP (male n = 17; 76.2%), mean age 9 y 8 m, SD 1 y 1 month (range 8 y 3 m to 12 y 6 m) were randomised into the intervention group (n = 9) or a waitlist control group. A mixed-methods approach with an explanatory sequential design was used, with a randomised controlled trial followed by qualitative interviews. Participants were assessed on measures of intelligence, academic ability, attention and executive functioning, and social-emotional functioning at baseline, then after completing the training, or the waitlist period. Analyses included ANCOVAs and paired samples t tests. Semi-structured interviews explored participants' experiences with the training. RESULTS AND OUTCOMES Training completion was low with a mean of 16.9 modules completed out of 55 available. No significant effect of training was found for the primary outcome of intelligence, or for any secondary outcomes. Participants reported barriers and facilitators for accessing the program. IMPLICATIONS Cognitive training programs addressing relational framing ability may require significant modifications before they can be effectively tested with children with CP.
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Affiliation(s)
- J Wotherspoon
- Queensland Cerebral Palsy & Rehabilitation Research Centre, Centre for Children's Health Research, The Faculty of Medicine, The University of Queensland, Brisbane, Australia.
| | - K Whittingham
- Queensland Cerebral Palsy & Rehabilitation Research Centre, Centre for Children's Health Research, The Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - J Sheffield
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - R N Boyd
- Queensland Cerebral Palsy & Rehabilitation Research Centre, Centre for Children's Health Research, The Faculty of Medicine, The University of Queensland, Brisbane, Australia
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LaForme Fiss A, Chiarello LA, Hsu LY, McCoy SW. Adaptive behavior and mastery motivation in children with physical disabilities. Physiother Theory Pract 2024; 40:1616-1627. [PMID: 36847241 DOI: 10.1080/09593985.2023.2181118] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/30/2022] [Accepted: 02/09/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Adaptive behavior consists of conceptual, social, and practical skills and describes the ability of individuals to manage environmental demands, interact with others, and engage in activities to meet ones needs. Mastery motivation is an intrinsic characteristic that enables persistence when attempting to master a skill. Children with physical disabilities often demonstrate less effective adaptive behaviors and lower mastery motivation than their peers without disabilities, which may subsequently impact development and participation in daily activities. Therefore, it may be beneficial for pediatric rehabilitation practitioners to focus intentionally on facilitating effective adaptive behaviors in children with physical disabilities as they aim to support child development and function. OBJECTIVE This perspective paper highlights the importance of adaptive behavior for children with physical disabilities, discusses methods of assessment, and illustrates intervention principles and strategies to support the development of appropriate adaptive behaviors across childhood. Key intervention principles include: 1) engage children and address motivation; 2) collaborate with others; 3) support real-life meaningful experiences; 4) scaffold the just-right challenge; and 5) guide children in discovering solutions.
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Affiliation(s)
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA USA
| | - Lin-Ya Hsu
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA USA
| | - Sarah Westcott McCoy
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA USA
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Lin CL, Lin HY, Wang PJ. Association between Mastery Motivation, Executive Function, and Daily Participation of Young Children with and without Global Developmental Delays. CHILDREN (BASEL, SWITZERLAND) 2024; 11:220. [PMID: 38397332 PMCID: PMC10887173 DOI: 10.3390/children11020220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
This study aimed to examine the group differences in participation level between children with and without global delays and to explore the associations between mastery motivation, executive function, and participation in young children with and without global developmental delays (GDD). Methods: we recruited 26 children with GDD aged 2 to 5 years and 26 children with sex- and mental age-matched developing typically (TD). The participants were assessed child development using the standardized developmental test, and their mothers were asked to fill in questionnaires, including the revised Dimension of Mastery Questionnaire (DMQ 18) with preschool version to assess mastery motivation, the Behavior Rating Inventory of Executive Function with preschool version (BRIEF-P) to assess executive function, and the Young Children's Participation and Environment Measure (YC-PEM) used to obtain participation levels. Results and conclusions: young children with GDD showed significantly lower participation levels at home, daycare, and community than TD group. We found that for young children, child mastery pleasure, health condition, and total persistence were significant predictors of child participation. Therefore, coaching parents to observe and facilitate their children's motivation and executive function, as well as child developmental abilities, is important in order to enhance children's participation in daily activities.
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Affiliation(s)
- Chien-Lin Lin
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung 413305, Taiwan;
| | - Pei-Jung Wang
- Department of Physical Therapy, Asia University, Taichung 413305, Taiwan
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Sand K, Starrfelt R, Robotham RJ. Cognitive Functioning and Assessment in Adults with Cerebral Palsy: A Scoping Review. Dev Neurorehabil 2024; 27:57-67. [PMID: 38702978 DOI: 10.1080/17518423.2024.2347991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
In this scoping review, we summarize the current knowledge of cognitive functioning in adults with cerebral palsy (CP), and identify the neuropsychological tests typically used in this population. 39 studies from the period January 1990 - August 2023 were included in the review, and they differ widely in their aims and approach to studying cognition. Very few studies have cognitive assessment as their core aim and use a neuropsychological test battery. The included studies show great variability in reported intelligence and cognitive functioning in adults with CP, and cognitive deficits have been reported in all cognitive domains. Most of the studies suffer from methodological limitations, and there is ample room for improvement within the field. We conclude by suggesting a number of recommendations that may contribute to increasing our understanding of cognitive impairments in adults with CP.
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Smith ZR, Holmbeck GN. Cross-Lag Model of Medical Responsibility and Skills in Youth With Spina Bifida. J Pediatr Psychol 2021; 46:1119-1129. [PMID: 34313781 DOI: 10.1093/jpepsy/jsab055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/22/2021] [Accepted: 04/29/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study examined bidirectional associations between mother- and father-reported medical responsibility and medical skill mastery in youth with spina bifida (SB). METHODS Participants were 140 youth with SB and their parents who participated in three waves of a longitudinal study across four years (ages 8-15 years at Time 1). Mother- and father-report of both medical responsibility and medical skill mastery were used, and age and estimated intelligence quotient were included as covariates, in cross-lagged models. RESULTS The cross-lagged model provided evidence for significant bidirectional associations between mother-reported medical responsibility and skill mastery across time (root mean square error of approximation=0.09, comparative fix index=0.97). These paths showed that higher levels of child responsibility predicted an increase in skill mastery and that higher levels of mastery predicted an increase in child responsibility across time. Moreover, based on mother-report, sharing of responsibility had stronger effects on increases in skill mastery (Time 1 to Time 2 β=.25, Time 2 to Time 3 β=.27) than skill mastery had on increases in child responsibility (Time 1 to Time 2 β=.08, Time 2 to Time 3 β=.07). The only significant cross-lagged path for father-report was from Time 1 skill mastery to Time 2 responsibility (β=.34). CONCLUSIONS Mothers perceive a bidirectional relationship between responsibility and skill mastery across time, whereas fathers appear to mainly consider how skills might affect a subsequent increase in responsibility sharing. Thus, it is important to consider both parents' perspectives when working to increase medical autonomy in youth with SB.
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Affiliation(s)
- Zoe R Smith
- Department of Psychology, Loyola University Chicago
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Winning AM, Stern A, Rausch JR, Starnes M, Holmbeck GN. [Formula: see text]Neurocognitive predictors of adaptive functioning trajectories among youth with spina bifida. Child Neuropsychol 2021; 27:447-467. [PMID: 33386061 PMCID: PMC8035277 DOI: 10.1080/09297049.2020.1862076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
Little is known about how youth with spina bifida (SB) acquire adaptive functioning skills across development. Therefore, the current study examined: (1) trajectories of adaptive functioning in youth with SB as they transitioned from childhood into adolescence, and (2) neuropsychological functioning as a potential risk factor for long-term adaptive functioning difficulties. Participants (n = 131 youth with SB) were recruited as part of a larger ongoing longitudinal study. Growth curves were used to examine changes over time across six adaptive functioning skills: communication, self-direction, functional academics, social, self-care, and home living skills. Additionally, youth's attention and executive functioning (i.e., working memory, planning/organizational skills, cognitive flexibility, inhibition) were assessed via questionnaires and performance-based assessments, and entered as predictors in the models. Youth's communication, self-direction, functional academics, self-care, and home living skills increased over time across age, whereas youth's social skills did not. Scaled scores for youth's social, communication, self-direction, and functional academics skills were generally within normal limits, whereas those for self-care and home living skills fell in the borderline range. Better attention and executive functioning predicted a higher intercept for many adaptive functioning abilities at 11.5 years old, above and beyond the influence of IQ. However, these variables did not predict growth in adaptive functioning. Results indicate that youth with SB acquire skills across development to better meet the demands of daily life. However, youth with poorer neurocognitive functioning may demonstrate adaptive functioning deficits in early childhood and benefit from timely intervention.
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Affiliation(s)
- Adrien M. Winning
- Loyola University Chicago, Psychology Department, 1032 W. Sheridan Road, Chicago, IL 60660
| | - Alexa Stern
- Loyola University Chicago, Psychology Department, 1032 W. Sheridan Road, Chicago, IL 60660
| | - Joseph R. Rausch
- The Research Institute at Nationwide Children’s Hospital, Center for Biobehavioral Health, 700 Children’s Drive, Columbus, OH 43205
| | - Meredith Starnes
- Loyola University Chicago, Psychology Department, 1032 W. Sheridan Road, Chicago, IL 60660
| | - Grayson N. Holmbeck
- Loyola University Chicago, Psychology Department, 1032 W. Sheridan Road, Chicago, IL 60660
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Stern A, Winning A, Ohanian D, Driscoll CFB, Starnes M, Glownia K, Holmbeck GN. Longitudinal associations between neuropsychological functioning and medical responsibility in youth with spina bifida: The moderational role of parenting behaviors. Child Neuropsychol 2020; 26:1026-1046. [PMID: 32308112 PMCID: PMC7544676 DOI: 10.1080/09297049.2020.1751098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
For youth with spina bifida (SB), the transfer of medical responsibilities from parent- to self-management is an important component of autonomy development. Youth with SB are at risk for neurocognitive impairments with inattention and executive dysfunction, which may impact their ability to take responsibility for medical tasks. However, adaptive parenting may buffer against the negative impact of executive/attentional dysfunction on levels of medical responsibility. Thus, this study examined the moderating roles of parenting behaviors and child age on the longitudinal associations between neuropsychological functioning and medical responsibility in youth with SB. Participants were recruited as part of a larger, longitudinal study. Youth with SB (N = 89, Mage = 11.10 years) completed a neuropsychological battery of executive functioning and attention measures at Time 1 (T1). Parents reported on youth's executive functioning/attention skills at T1, and child medical responsibility two years later at Time 2 (T2). Observational methods were used to assess parenting behaviors (warmth, behavioral and psychological control) at T1. Attention and cognitive shifting skills at T1 were positively related to child medical responsibility at T2. Two-way interactions between planning/organizing skills and paternal acceptance, and planning/organizing skills and paternal psychological control, were found. A three-way interaction between cognitive shifting skills, maternal acceptance, and child age was found. When conceptualizing risk factors for low medical responsibility in youth with SB, it is important to consider the family context beyond individual, cognitive factors. The results are discussed within the wider context of social-ecological models of medical responsibility.
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Affiliation(s)
- Alexa Stern
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | - Adrien Winning
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | - Diana Ohanian
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | | | - Meredith Starnes
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
| | - Karen Glownia
- Psychology Department, Loyola University Chicago , Chicago, IL, USA
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Durfee EH, Garrett LH, Johnson A. Promoting Independence with a Schedule Management Assistant that Anticipates Disruptions. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2019; 4:19-49. [DOI: 10.1007/s41666-019-00060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 06/26/2019] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
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Öhrvall AM, Bergqvist L, Hofgren C, Peny-Dahlstrand M. “With CO-OP I’m the boss” – experiences of the cognitive orientation to daily occupational performance approach as reported by young adults with cerebral palsy or spina bifida. Disabil Rehabil 2019; 42:3645-3652. [DOI: 10.1080/09638288.2019.1607911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Ann-Marie Öhrvall
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena Bergqvist
- Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Habilitation & Health, Västra Götalandsregionen, Borås, Sweden
| | - Caisa Hofgren
- Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Habilitation & Health, Västra Götalandsregionen, Gothenburg, Sweden
| | - Marie Peny-Dahlstrand
- Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regional Rehabilitation Centre at Queen Silvia’s Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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